Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China.
Chin Med J (Engl). 2010 Jul;123(13):1690-4.
Morphologic imaging after radiofrequency ablation (RFA) of liver metastases is hampered by an inflammatory response in the ablation margin, making the identification of local tumor progression (LTP) difficult. The aim of this study was to evaluate the efficacy of early (18)F-FDG PET/CT scanning to monitor the effectiveness of RFA in colorectal liver metastases.
Twelve patients with 20 metastases were treated with RFA for colorectal liver metastases. They underwent PET/CT within 2 weeks before RFA and within 24 hours after RFA (so termed "early PET/CT"). PET/CT was repeated at 1, 3, and 6 months, and then every 6 months after ablation. The standard of reference was based on available clinical and radiological follow-up data.
Early PET/CT revealed total photopenia in 16 RFA-treated metastases, which were found to be without residual tumor on the final PET/CT scan. Three RFA-treated metastases with focal uptake were identified as local tumor progression, which necessitated further treatment. One RFA-treated metastasis with rim-shaped uptake was regarded as inflammation. The results of the early PET/CT scanning were consistent with the findings of the final follow-up.
PET/CT performed within 24 hours after RFA can effectively detect whether residual tumor exists for colorectal cancer liver metastases. The results can guide further treatment, and may improve the efficacy of RFA.
射频消融（RFA）治疗肝转移瘤后，由于消融边缘的炎症反应，形态学成像会受到阻碍，使得局部肿瘤进展（LTP）的识别变得困难。本研究旨在评估早期（18）F-FDG PET/CT 扫描在监测结直肠癌肝转移瘤 RFA 效果中的作用。
12 例 20 个肝转移灶的结直肠癌患者接受 RFA 治疗。他们在 RFA 前 2 周内和 RFA 后 24 小时内进行 PET/CT 检查（称为“早期 PET/CT”）。PET/CT 在消融后 1、3、6 个月以及之后每 6 个月重复一次。参考标准基于可用的临床和影像学随访数据。
早期 PET/CT 显示 16 个 RFA 治疗转移灶完全无放射性摄取，最终 PET/CT 扫描显示无残留肿瘤。3 个有局灶摄取的 RFA 治疗转移灶被确定为局部肿瘤进展，需要进一步治疗。1 个有边缘摄取的 RFA 治疗转移灶被认为是炎症。早期 PET/CT 扫描的结果与最终随访的结果一致。
RFA 后 24 小时内进行的 PET/CT 可以有效地检测结直肠癌肝转移瘤是否存在残留肿瘤。结果可以指导进一步的治疗，并可能提高 RFA 的疗效。
